Choice within abortion care pathways: perspectives of abortion care users on abortion methods and service options in England and Wales

The aim of this qualitative study is to explore abortion service users’ perceptions and comparative experiences of choice within abortion care pathways. In-depth interviews will be conducted with individuals who have sought abortion services in the study period, and who have at least one previous abortion experience. Participants will be recruited from BPAS and NHS services. For BPAS services, participants will be retrospectively recruited from a database of clients who have consented to be contacted about future research. For NHS services, patients will be invited to learn more about the research at the point of service by their health care professional, after the patient has completed their consultation, either by email or verbally at the end of the phone or in-person consultation. Interested participants will then be contacted by phone call or email by the researcher to provide more information, to answer any questions, confirm interest, go through the informed consent process, and arrange a time for the interview to take place. Informed consent will be recorded by the participant through an online form. Participants will be offered a digital copy of the information sheet and consent form if they wish. Interviews will be conducted by phone or web-call by the lead researcher, depending on the preference of the participant. Interviews will be semi-structured, using a topic guide. Interviews (including confirmation of verbal consent) will be audio-recorded and transcribed by the lead researcher. Data will be analysed using thematic analysis and findings will be disseminated through conference presentations, peer-reviewed journal articles, and a PhD thesis. Research results are intended to inform policies and practice surrounding the provision of choice within abortion care pathways in the UK

Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study

Objective To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. Methods Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. Results Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3–1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. Conclusions Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians’ threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection

Relative Abundance of Lipid Metabolites in Spermatozoa across Three Compartments

Peer reviewed: TrueFunder: NIHR Cambridge BRCFunder: core biochemical assay laboratory (CBAL)Funder: core metabolomic and lipidomic laboratory (CMAL)Male fertility, as manifest by the quantity and progressive motility of spermatozoa, is negatively impacted by obesity, dyslipidaemia and metabolic disease. However, the relative distribution of lipids in spermatozoa and the two compartments which supply lipids for spermatogenesis (seminal fluid and blood serum) has not been studied. We hypothesised that altered availability of lipids in blood serum and seminal fluid may affect the lipid composition and progressive motility of sperm. 60 men of age 35 years (median (range 20–45) and BMI 30.4 kg/m2 (24–36.5) under preliminary investigation for subfertility were recruited at an NHS clinic. Men provided samples of serum and semen, subject to strict acceptance criteria, for analysis of spermatozoa count and motility. Blood serum (n = 60), spermatozoa (n = 26) and seminal fluid (n = 60) were frozen for batch lipidomics analysis. Spermatozoa and seminal fluid had comparable lipid composition but showed marked differences with the serum lipidome. Spermatozoa demonstrated high abundance of ceramides, very-long-chain fatty acids (C20-22), and certain phospholipids (sphingomyelins, plasmalogens, phosphatidylethanolamines) with low abundance of phosphatidylcholines, cholesterol and triglycerides. Men with spermatozoa of low progressive motility had evidence of fewer concentration gradients for many lipid species between blood serum and spermatozoa compartments. Spermatozoa are abundant in multiple lipid species which are likely to contribute to key cellular functions. Lipid metabolism shows reduced regulation between compartments in men with spermatozoa with reduced progressive motility